Saturday, 21 June 2014

Most Read Topics-Radiotherapy Side Effects

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Radiotherapy

Introduction to Radiotherapy

Side effects -- General

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Introduction

Patient
education on cancer is a must & involves dissemination of
information and knowledge about oncology support systems. The treatment
of cancer is multidisciplinary and involves surgery, chemotherapy,
radiation, rehabilitation & psychosocial support. A multidimensional
approach is the best way to deal with this disease.

Our endeavour is to provide you the best available information
regarding cancer of various sites, with special emphasis on radiation
therapy. Radiation is used in a definitive, adjuvant or palliative
setting, depending on the type & stage of cancer. In this section,
we are attempt to demystify radiation therapy and to provide you
information regarding the latest developments in the field of radiation
therapy.

Introduction to radiation therapy

Side effects

Precautions

Frequently asked questions regarding radiotherapy.

New developments in the field of radiotherapy.

Introduction to Radiotherapy.
Cancer management mandates a multimodality approach and radiotherapy
plays a major role in the management of cancer. Radiation is the main
treatment for most head neck cancers and cervix cancers. It is used as
an adjuvant treatment (treatment after definitive treatment, to prevent
reccurence) for breast cancer, gastrointestinal cancers, head neck
cancer, soft tissue sarcomas and many more.
What is radiotherapy and how does it work?
Radiation is broadly divided into X rays (Photons) and particulate
radiation. Diagnostic radiology uses low energy X rays for imaging while
in radiotherapy high energy X rays are used to treat tumor. Particulate
radiation includes radiation by electrons, protons or neutrons. The
following details pertain to X ray based radiation since this is the
form used most often.
The photons present in the radiation
admenisterd ionizes the water in the cell and induces formation of
free radicals which can damage of genetic material (DNA). This
damage may be lethal and can cause death of the tumour cell. However,
often the damage is not enough to cause cell death i.e. it is is
sublethal. This may be converted to lethal damage by repeated exposure
to radiation; radiation is therefore fractionated and given over
multiple sittings. Normal cells are also affected adversely by
radiation but have the capacity of repair. Within their tolerance
limits, the cells reapair themselves and the damage is transient and
reversible.

Radiation side effects -- General

Before starting any radiation treatment, check with your doctor about
the side effects of radiation. Some patients may have severe side
effects while others have only mild symptoms. It is difficult to predict
that how your body will react to radiation.

SIDE EFFECTS

TREATMENT OF SIDE EFFECTS (please consult your doctor before using any of the advised medicine).

This side effect is a function of dose. If you are getting radiation
which will exceed more than 4 weeks probably you will have this
radiation reaction. Avoid any cream, lotion oil soap over the skin. Wear
loose cotton clothing. Review with your radiation oncology team every
week.

3

Hair fall in the area where radiation is being given. Hair fall can
be permanent or temporary depending on the dose of radiation.

Consult your doctor regarding the nature of hair fall. Whether
permanent or temporary. Now a day's natural looking wigs are available
in market.

4

Nausea & Vomiting. Usually mild in nature but in some patient it can be severe.

Drugs to control vomiting will be usually started by your doctor. If
nausea and vomiting is still bothering you please consult your doctor.

5

Bone marrow suppression.

It presents as fall in your hemoglobin or WBC count or Platelet count
or combination of these or all of these. If you have received
chemotherapy earlier then chances of developing these side effects are
more. You will be required to undergo weekly blood checks. If your
hemoglobin is low you will require blood transfusion and for low
platelet, platelet transfusion. For low WBC you will be given GCSF
injections which enhances the capacity of bone marrow to produce WBC.

Radiation side effects -- Head Neck Cancer

Before starting any radiation treatment, check with your doctor about
the side effect of radiation. Some patients may have severe side
effects while others have only mild symptoms. It is difficult to predict
that how your body will react to radiation.

SIDE EFFECTS

TREATMENT OF SIDE EFFECTS. (please consult your doctor before using any of the advised medicine)

1

Mucositis: You can have ulcer in oral cavity and throat. While on radiation this usually occurs third week onward.

Oral hygiene is must and require betadine gargles. If mucositis is
very painful then painkiller are required ranging from non-opioids to
opioids.
Mouth dissolving antifungals.
Syrup containing local anesthesia.
Avoid hot food and beverages.
Suck ice chips 5 to 6 times daily.

2

Dysphagia: difficulty in swallowing.

If dysphagia is mild then syrup containing local anesthesia will
help. Take 2 TSF in 1/4th glass of water and dissolve 1/2 tablet of
dispirin. Gargle with this solution and swallow slowly. Take feeds after
15 minutes.
If dysphagia is severe then feeding tube may be required which is placed via nose in the stomach.

3

Salivary gland toxicity: In the initial few week excessive salivation
occurs followed by thick sticky saliva in later part of the treatment.

Syrups containing mucolytics can help. Drink plenty of water.
Oral artificial saliva can be of help.

4

Laryngeal toxicity: hoarseness of voice can occur in later part of the treatment.

Voice rest is advised. If there is breathing difficulty and you hear
strange sound while breathing please immediately consult your doctor.

Radiation side effects -- Pelvic Malignancies.

Before starting any radiation treatment, check with your doctor about
the side effect of radiation. Some patients may have severe side
effects while others have only mild symptoms. It is difficult to predict
that how your body will react to radiation.

SIDE EFFECTS

TREATMENT OF SIDE EFFECTS. (please consult your doctor before using any of the advised medicine)

1

Diarrhea: Loose motions

Drink plenty of fluids.
Anti diarrheal medication as prescribed by your doctor.
Avoid milk in diet and oily and spicy food.
Pain killer and antispasmodic medications as prescribed by your doctor.
You may require hospital admission for intravenous fluid
administration -- if your loose motions are not responding to
medications.

2

Genitourinary complications: you can have burning micturation or increase frequency of micturation.